الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Congenital glottic web is a rare congenital anomaly comprise about 5 % of congenital laryngeal anomalies. Glottic web is not only a problem of voice in many cases; it should be taken seriously when there is respiratory distress. Recurrence and unsatisfactory voice outcome has always been the mainstay dilemma in the treatment. The aim of the work: to evaluate voice outcome and incidence of web reformation after different types of congenital glottic web surgeries including endoscopic excision using diode Laser followed by either MMC application or silicone keel insertion and open approach including open LTR using costal cartilage graft. Materials & methods: In this prospective comparative study, 20 subjects were examined, divided into two groups according to glottic web thickness and involvement of subglottic region. Thin web without subglottic component was managed by laser endoscopic excision followed by either MMC application or silicone keel insertion while thick web with subglottic extension was managed by open repair technique. Both groups were assessed both preoperative and postoperative for voice evaluation subjectively and objectively. Results: Postoperative follow up for at least 3 months is of extreme value in order to early detect recurrence and to identify possible complications as early as possible. Improvement of voice parameters is usually mild and no specific technique has marked efficacy over another. Subglottic component has always been the cornerstone in management. When it’s properly identified along with estimation of the web thickness, we can choose the right surgical technique. Physical barrier in the form of silicone keel after endoscopic excision or endolaryngeal stent after open repair techniques which separates vocal folds after interference is mandatory to avoid web reformation. Glottic adhesions and web reformation are associated with poor phonetic outcome.